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During the last ten years, the inclusion of education in health information systems has assumed an important role in graduate programs for health professionals. More recently, attention has focused on undergraduate programs. Throughout the world schools of nursing, organisations and associations are addressing the issue of educational offerings in nursing informatics. This paper reports on the status of nursing informatics at undergraduate level. Nurse academics from Gavle and Lund in Sweden, and from Melbourne and Sydney in Australia, took part in a survey of the respective nursing courses. The purpose of the study was to identify and describe examples of types of nursing informatics courses in Australia and Sweden A convenient sample of academics were approached and interviewed The results of the survey illustrate, in the schools surveyed, the slow emergence of nursing informatics into nursing curricula.

3. Is Gender always reported in Blood Pressure Research? (poster)

Hofsten, Anna

University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för medicinsk vetenskap.

Aim. The aim of the present study was to investigate students’ opinions about a web-based distance learning course that was part of a specialist education programme.

Design. Survey.

Method. The study was a descriptive survey with both qualitative and quantitative questions.

Results. The students found the web-based course very useful for their theoretical and professional development. New perspectives on ageing, increased knowledge about analysing and describing theories as well as practising interviews and qualitative analysis as methods were appreciated by the students.

Conclusions. One way for RNs in Sweden to get a university specialist education in the care of older people is to have a distance web-based course, as it allows flexibility and improves the students’ theoretical and professional knowledge and communication skills.

Relevance for clinical practice. Managers working in care for older people settings and educators will be interested in this study’s finding that distance learning is a useful strategy for providing education for RNs who work with older people.

It is a well-known fact that smoking is associated with a reduction in exhaled nitric oxide (NO) levels. There is, however, limited knowledge relating to the smoking-induced changes in production or exchange of NO in different compartments of the airways. This study comprised 221 adult subjects from the European Community Respiratory Health Survey 11, who were investigated in terms of their exhaled NO, lung function, immunoglobulin E sensitisation and smoking habits. The following parameters were determined using extended NO analysis: airway tissue nitric oxide concentration (Caw,NO), airway transfer factor (or diffusing capacity) for nitric oxide (Daw,NO), alveolar nitric oxide concentration (CA,No) and fractional exhaled nitric oxide concentration at a flow rate of 50 mL(.)s(-1) (FeNO,0.05). Maximum total airway nitric oxide flux (J'aw,NO) was calculated from Daw,NO(Caw,NO-CA,NO). Current smokers (n=35) exhibited lower (geometric mean) FeNO,0.05 (14.0 versus 22.8 ppb), Caw,NO (79.0 versus 126 ppb) and J'aw,NO (688 versus 1,153 pL(.)s(-1)) than never-smokers (n=111). Ex-smokers (n=75) were characterised by lower FeNO,0.05 (17.7 versus 22.8 ppb) and Jaw,NO (858 versus 1,153 pL-s(-1)) than never-smokers. These relationships were maintained after adjusting for potential confounders (sex, age, height, immunoglobulin E sensitisation and forced expiratory volume in one second), and, in this analysis, a negative association was found between current smoking and CA,NO. Snus (oral moist snuff) consumption (n=21) in ex-smokers was associated with an increase in Daw,NO and a reduction in Caw,No, after adjusting for potential confounders. Passive smoking was associated with a higher CA,NO. Using extended nitric oxide analysis, it was possible to attribute the reduction in exhaled nitric oxide levels seen in ex- and current smokers to 6 lower total airway nitric oxide flux in ex-smokers and reduced airway and alveolar nitric oxide concentrations in current smokers. The association between snus (oral tobacco) use and reduced nitric oxide concentrations in the airways and increased nitric oxide transfer from the airways warrants further studies.

Background: A positive association between IgE sensitisation and exhaled NO levels has been found in several studies, but there are no reports on the compartment of the lung that is responsible for the increase in exhaled NO levels seen in IgE-sensitised subjects. Methods: The present study comprised 288 adult subjects from the European Community Respiratory Health Survey II who were investigated in terms of lung function, IgE sensitisation ( sum of specific IgE), smoking history and presence of rhinitis and asthma. Mean airway tissue concentration of NO (Caw(NO)), airway transfer factor for NO (Daw(NO)), mean alveolar concentration of NO (Calv(NO)) and fractional exhaled concentration of NO at a flow rate of 50 mL s(-1) ( FENO0.05) were determined using the extended NO analysis. Results: IgE-sensitised subjects had higher levels ( geometric mean) of FENO 0.05 (24.9 vs. 17.3 ppb) ( p < 0.001), Daw(NO) ( 10.5 vs. 8 mL s(-1)) ( p = 0.02) and Caw(NO) (124 vs. 107 ppb) ( p < 0.001) and positive correlations were found between the sum of specific IgE and FENO 0.05, Caw(NO) and Daw(NO) levels ( p < 0.001 for all correlations). Sensitisation to cat allergen was the major determinant of exhaled NO when adjusting for type of sensitisation. Rhinitis and asthma were not associated with the increase in exhaled NO variables after adjusting for the degree of IgE sensitisation. Conclusion: The presence of IgE sensitisation and the degree of allergic sensitisation were related to the increase in airway NO transfer factor and the increase in NO concentration in the airway wall. Sensitisation to cat allergen was related to the highest increases in exhaled NO parameters. Our data suggest that exhaled NO is more a specific marker of allergic inflammation than a marker of asthma or rhinitis.

The number of overweight (BMI > 25) and obese (BMI > 30) people is rising worldwide and also in Sweden where the prevalence is 44 %. In the municipality of Sandviken more than half of the population is overweight or obese and that could lead to poor health and/or sickness. It is important to find the persons in risk of developing overweight/obesity and the people who already are overweight/obese to be able to prevent or to give treatment. Early discovery and correct treatment will of course benefit the patient but it will also lower the costs for the healthcare system. The purpose of this study was to investigate the practical use of a program for identification and treatment of overweight/obesity in three health clinics in the municipality of Sandviken during two months in 2005.

Method

The starting-point of the program is to measure BMI. BMI should be measured on all patients who seek care and treatment at the health clinic – not just the ones who want help because of overweight or obesity. The first control was therefore to see how many of all the patients who visited the health clinic who got their BMI measured. The second control was to see how many of those patients who got treatment according to the program.

Results

BMI were measured on 6 % of all the patients who visited the health clinics. Out of these patients, 38 % had a BMI that should lead to an offer of treatment according to the program. Almost all of the 38 % did get treatment but for other reasons and diagnoses than overweight or obesity which only one fifth of the 38 % got. Very few got the diagnose "overweight/obesity".

Conclusions

With such low figures of BMI-measuring and treatment according to the program, you could suspect that the program is not in use at all. The reason for this could be that the staff at the health clinics does not know that the program exists or that they do not find the program user-friendly. It is very important to use effective methods for identification and treatment of overweight/obesity, but no matter what method – the most important thing is that the staff who is supposed to adopt these methods is well acquainted with them and also finds them useful in their daily work.

Dyspepsia is a common disorder. A lack of effective therapies for managing dyspepsia may invite use of complementary and alternative medicine (CAM). The aim of this study was to elucidate CAM methods and their perceived effects in a middle-sized community in Sweden. Group interviews were used. Persons with uninvestigated dyspepsia, according to the Rome II criteria, were included. Data were studied systematically using manifest content analysis. A total of 25 persons (13 women and 12 men) were assigned to five different groups. The CAM methods used by participants were categorized as follows: (1) nutritional, (2) drug/biological, (3) spiritual/psychological, and (4) physical activity. In this study, 26 CAM methods associated with various effects were identified and all persons had used at least one method.

Occurrence of bacteraemia and fungemia is a serious condition with high mortality and the incidence is increasing worldwide. The aim of this study was to survey the occurrence of bacteria and fungi in blood cultures from adult patients domiciled in the county of Gävleborg during one year and also to calculate the incidence and mortality in the same geographical area.

Method

This is a descriptive epidemiologic study, based on all episodes of blood cultures analyzed at the Microbiology laboratory, Gävle hospital during 2005. Patients from 20 years of age, domiciled in the county of Gävleborg at the date of drawing the blood culture, where included in the study. Criteria of exclusion were negative blood cultures and cultures which were classified as contaminants.

Results

Altogether there were 4 564 blood cultures analyzed, resulting in 524 (11 %) positive cultures for further study. There were 442 patients (48 % women) involved in 499 episodes with confirmed bacteraemia or fungemia. Gram positive bacteria represented 52 %, gram negative 45 % and fungi 3 %. The most frequently isolated bacterium was Escherichia coli followed by Staphylococcus aureus. In women, Escherichia coli was the most common bacterium, and there was a significant difference between the genders (p= 0.004). In men, Staphylococcus aureus was the dominant species (p= 0.027). Streptococcus pneumoniae was more common in women (p= 0.005). The incidence of bacteraemia and fungemia in the county of Gävleborg was 235/100 000 inhabitants above the age of 20 (women, 223/100 000 men, 247/100 000). The incidence increased with age and the mean age was 70.2 years. The mortality within 30 days after the last positive blood culture was 22 % (97 patients). Escherichia coli was the most common bacteria diagnosed among those who died. The mortality in fungemia was 66 %. There was no significant difference in incidence or mortality between the two provinces Gästrikland and Hälsingland. Patients with bacteraemia and fungemia were initially cared for at all medical care units at the three hospitals in the county.

Conclusion

The incidence of bacteraemia/fungemia in the county of Gävleborg was 235/100 000 inhabitants. The most common bacteria in patients with confirmed bacteraemia were Escherichia coli and Staphylococcus aureus. Increasing age was a contributing risk factor. Patients with fungemia had considerably higher mortality compared to patients with bacteraemia. There where no significant differences in mortality between the two provinces.